testicular with fever

Overview

This article covers pain, swelling, or discomfort in one or both testicles (the male sex glands that make sperm) when it comes with a fever. A fever is a sign your immune system is fighting off an infection. When the testicles or nearby tubes become infected or inflamed, it can cause pain and a raised body temperature. This combination of symptoms usually points to an infection such as epididymitis (inflammation of the coiled tube at the back of the testicle) or orchitis (inflammation of the testicle itself).

Yes. Testicular pain is a common reason for men to visit a doctor or emergency department. Infections of the epididymis and testicle are frequently seen, especially in sexually active younger men and in older men with urinary problems.

It can affect males of any age. Young men aged 18–35 are more prone to infections linked to sexually transmitted infections. Older men may get it from urinary tract infections or an enlarged prostate. Children can also develop testicular infections, though some sudden testicle pain in boys is due to torsion, which is a different emergency.

Symptoms

Common symptoms

• Pain or ache in one testicle that often comes on gradually
• Swelling, redness, or warmth of the scrotum (the pouch of skin holding the testicles)
• A tender lump or enlarged testicle
• Fever, chills, or feeling generally unwell
• Painful or burning urination
• Discharge from the penis
• Discomfort in the groin or lower abdomen
• Pain during ejaculation

Symptoms in children

• A boy may complain of pain in the groin or testicle and have a fever
• He may limp or avoid walking because of discomfort
• The scrotum may look red, swollen, or tender to touch
• Nausea or vomiting along with sudden severe pain can also happen

Symptoms in older adults

• Fever and testicular pain may be accompanied by urinary frequency, urgency, or difficulty starting urination
• The pain may be dull and spread to the lower back or abdomen
• There may be a feeling of incomplete bladder emptying

Causes

Main causes

• Bacterial infection spreading from the bladder or urinary tract to the epididymis or testicle
• Sexually transmitted infections, such as chlamydia or gonorrhea, in younger sexually active men
• Viral infection, most commonly from the mumps virus in unvaccinated males
• Urinary tract infection or an enlarged prostate in older men
• Urine flowing backward into the epididymis, which can be due to heavy lifting or straining
• Injury or trauma to the scrotum that becomes infected

Risk factors

• Being sexually active without a condom
• Having a previous urinary tract infection or prostate infection
• Having an uncircumcised penis, which may increase the risk of some infections
• Recent surgery or medical procedure involving the bladder or urinary tract
• Using a urinary catheter
• Certain medications that affect the bladder or urinary flow
• History of testicular torsion or surgery in the groin area

When to see a doctor

See a doctor urgently if:

• Go to an emergency department if you have sudden, severe testicular pain, especially with a swollen or red scrotum, nausea, or vomiting.
• Call your local emergency number if you have had an injury to the scrotum and then develop fever or intense pain.

Book a routine appointment if:

• See a doctor within 24 hours if you have testicular pain with fever, chills, burning urination, or a tender lump.
• Also see a doctor soon if the pain is mild but lasts more than a few hours or if you notice unusual discharge.

Diagnosis

A doctor will ask about your symptoms, your sexual history, and any recent urinary problems. They will examine your scrotum, testicles, and abdomen. They may gently lift the scrotum to see if the pain lessens, which is a sign that points more toward infection than torsion. You may be asked for a urine sample and sometimes a swab from the penis to test for bacteria or sexually transmitted infections.

Tests that may be done

• Urine test to check for bacteria, blood, or signs of infection
• Swab from the urethra (the tube that carries urine from the bladder out of the body) to test for chlamydia or gonorrhea
• Blood tests to look for a high white blood cell count or markers of inflammation
• An ultrasound scan of the scrotum to see blood flow and check for an abscess or torsion

What to expect at your appointment

The physical exam may be uncomfortable but is usually brief. A urine sample is painless, and a swab feels similar to a routine infection screen. An ultrasound is quick and uses a cooling gel; it is not painful. You will usually get some information about what the doctor suspects before you leave the appointment. If the cause is not clear, you may be referred to a urologist (a specialist in the urinary and male reproductive systems) for further tests.

Treatment

Treatment depends on the cause. If the condition is bacterial, antibiotics are the mainstay of care. If it is caused by a virus, like mumps orchitis, treatment focuses on pain relief and rest, because antibiotics do not work against viruses. In the case of torsion, surgery is needed urgently to save the testicle. Your doctor will recommend the right plan for you.

Self-care at home

• Rest and elevate your scrotum by wearing supportive underwear or lying down with a rolled towel under it
• Apply a cold pack wrapped in a cloth to the scrotum for 10–15 minutes at a time to reduce swelling
• Take over-the-counter pain relievers such as paracetamol or ibuprofen as directed on the label, or as recommended by your pharmacist or doctor
• Drink plenty of fluids and avoid lifting heavy objects or straining
• Until the infection clears, avoid sexual activity if it is related to an STI

Medical treatments

Doctors usually prescribe a course of antibiotics for bacterial infections like epididymitis. The specific medicine depends on the likely germ and your history. They may also recommend anti-inflammatory pain relief and, in some cases, injectable medicines if the infection is severe. For viral infections, treatment is supportive, meaning rest, fluids, and pain control. If you have an abscess (a pocket of pus), it may need to be drained.

When is surgery considered?

Surgery is required for testicular torsion, a condition where the spermatic cord twists and cuts off blood flow to the testicle. This is a medical emergency. Surgery may also be needed if an abscess forms that cannot be drained with a needle, or if a severe infection damages tissue.

Living with this condition

During an acute infection, rest is important. Wear supportive underwear or athletic support to keep the scrotum still. Avoid strenuous exercise, heavy lifting, and long periods of sitting without breaks. Finish your full course of antibiotics even if you feel better before the last dose. Keep follow-up appointments so your doctor can confirm the infection has cleared.

Lifestyle tips

• Use condoms to reduce the risk of sexually transmitted infections, which can cause testicular infections
• Practice good hygiene, including washing the genital area daily
• Empty your bladder regularly and avoid holding urine for long periods
• Drink enough water to keep urine dilute and reduce irritation

Diet and exercise

There is no special diet for testicular infections, but eating a balanced diet with plenty of fruit, vegetables, and whole grains supports your immune system. Gentle exercise like walking is usually fine once acute pain settles, but avoid activities that jar or put pressure on the scrotum until symptoms improve. If you are not sure about a specific activity, ask your doctor.

Mental health and emotional wellbeing

Dealing with pain, embarrassment, or fear about the testicles can cause anxiety or stress. It is normal to feel worried. Remember that most testicular infections are temporary and treatable. If you feel overwhelmed, talk to your doctor or a counsellor. You may also find it helpful to speak with someone you trust about what you are going through.

Prevention

Not all cases can be prevented, but many can. Using condoms during sex greatly reduces the risk of sexually transmitted infections that cause epididymitis. Practising good hygiene, treating urinary tract infections promptly, and avoiding the use of urinary catheters unless strictly necessary also help. If you have a health condition that affects urine flow, following your doctor's advice can lower your risk.

Screening programmes

There is no routine screening for testicular infections. If you have symptoms, see a doctor. Men at higher risk because of sexual activity may benefit from regular STI screening, which can help catch and treat infections early.

Complications

If left untreated

• An abscess may form inside the scrotum, which needs surgical drainage
• Spread of infection to the blood (sepsis), a serious whole-body emergency
• Chronic pain in the testicle that lasts for months
• Shrinkage of the testicle from damage
• Infertility if both testicles are seriously affected or if the infection causes blockages in the sperm-carrying tubes

Long-term outlook

With prompt and proper treatment, the outlook is very good. Most men feel much better within a few days to a couple of weeks. Fertility is usually preserved, especially when only one testicle is involved and it is treated early. By following your doctor's plan and taking any prescribed medicines as directed, the risk of long-term problems is low.

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